| Katherine Suzanne Hetrick, LCSW | |
| 7969 Ashton Ave, Manassas, VA 20109-2885 | |
| (703) 792-7800 | |
| (703) 792-5699 | 
| Full Name | Katherine Suzanne Hetrick | 
|---|---|
| Gender | Female | 
| Speciality | Social Worker - Clinical | 
| Location | 7969 Ashton Ave, Manassas, Virginia | 
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. | 
| Identifier | Type | State | Issuer | 
|---|---|---|---|
| 1245833466 | NPI | - | NPPES | 
| Taxonomy | Type | License (State) | Status | 
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | 0904012420 (Virginia) | Primary | 
| Entity Name | Prince William County | 
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice | 
| Entity Identifiers | NPI Number: 1053402800 PECOS PAC ID: 7113912973 Enrollment ID: O20040420000249 | 
| Mailing Address | Practice Location Address | 
|---|---|
| Katherine Suzanne Hetrick, LCSW 7969 Ashton Ave, Manassas, VA 20109-2885 Ph: (703) 792-7800 | Katherine Suzanne Hetrick, LCSW 7969 Ashton Ave, Manassas, VA 20109-2885 Ph: (703) 792-7800 | 
| Mrs. Cynthia Rebecca Lane-hand, LICSW Clinical Social Worker Medicare: Not Enrolled in Medicare Practice Location: 7969 Ashton Ave, Manassas, VA 20109 Phone: 703-792-7800 Fax: 703-792-5699 | |
| Ms. Linda Diana Malone, LCSW Clinical Social Worker Medicare: Not Enrolled in Medicare Practice Location: 10530 Linden Lake Plz, 200, Manassas, VA 20109 Phone: 703-392-6707 | |
| Jennifer Sarisky, LCSW Clinical Social Worker Medicare: Medicare Enrolled Practice Location: 8575 Rixlew Ln, Manassas, VA 20109 Phone: 301-593-1315 Fax: 301-681-4699 | |
| Kelly Terry, LCSW Clinical Social Worker Medicare: Not Enrolled in Medicare Practice Location: 10535 Crestwood Dr, Suite 201, Manassas, VA 20109 Phone: 703-492-2686 | |
| Mary Lou Fahey, LCSW Clinical Social Worker Medicare: Not Enrolled in Medicare Practice Location: 7969 Ashton Ave, Manassas, VA 20109 Phone: 703-792-7800 Fax: 703-792-5699 | |
| Jacquelyn Marie Brannock, LCSW Clinical Social Worker Medicare: Medicare Enrolled Practice Location: 7969 Ashton Ave, Manassas, VA 20109 Phone: 703-792-7800 Fax: 703-792-5699 | |
| Gia Thi, LCSW Clinical Social Worker Medicare: Not Enrolled in Medicare Practice Location: 7982 Donegan Drive, Manassas, VA 20109 Phone: 571-723-9461 |